Title of Regulation: 18VAC150-20. Regulations Governing the Practice of Veterinary Medicine (amending 18VAC150-20-140, 18VAC150-20-172).

Statutory Authority: § 54.1-2400 of the Code of Virginia.

Public Hearing Information: No public hearings are scheduled.

Public Comment Deadline: December 19, 2012.

Effective Date: January 3, 2013.

Agency Contact: Leslie L. Knachel, Executive Director, Board of Veterinary Medicine, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone (804) 367-4468, FAX (804) 527-4471, or email leslie.knachel@dhp.virginia.gov.

Basis: Section 54.1-2400 of the Code of Virginia establishes the general powers and duties of health regulatory boards including the responsibility of the Board of Veterinary Medicine to promulgate regulations and administer a licensure and renewal program.

Purpose: The purpose of the amended regulation is to establish grounds for a finding of unprofessional conduct that involves fraud, deceit, or misrepresentation. Currently, there is no such provision, which has resulted in an inability to appropriately address complaints against veterinarians in a few cases. The purpose of the amendment is to ensure the health and safety of citizens by establishing board authority to take a disciplinary action in cases where there clearly has been fraud, deceit, or misrepresentation to the board or to a client, or both.

Rationale for Using Fast-Track Process: This regulation is appropriate for the fast-track process because there is no disagreement about whether the board should have authority to take disciplinary action for fraud, deceit, or misrepresentation. There is no controversy in clearly specifying the board's authority or in clarifying the ability to delegate veterinary tasks.

Substance: An amendment to regulations establishing grounds for unprofessional conduct (18VAC150-20-140) is adopted to include committing an act constituting fraud, deceit, or misrepresentation in dealing with the board or in the veterinarian-client-patient relationship. An amendment to 18VAC150-20-172 on delegation of duties by a veterinarian is adopted to clarify that the delegation may occur by any means, either electronically, in writing, or in person.

Issues: The primary advantage to the public would be the ability of the board to discipline a licensee who is found guilty of fraud, deceit, or misrepresentation to the board or to his clients. There are no disadvantages to the public, which is better protected if the board has authority to act in such cases.

There are no advantages or disadvantages to the agency.

Department of Planning and Budget's Economic Impact Analysis:

Summary of the Proposed Amendments to Regulation. The Board of Veterinary Medicine (Board) proposes 1) to add committing fraud, deceit, or misrepresentation in dealing with the Board or with the customers as grounds for unprofessional conduct and 2) to clarify that delegation of veterinarian duties can be done in writing or in person in addition to delegation by electronic means.

Result of Analysis. The benefits likely exceed the costs for all proposed changes.

Estimated Economic Impact. The Board of Veterinary Medicine (Board) proposes to add committing fraud, deceit, or misrepresentation in dealing with the Board or with the customers as grounds for unprofessional conduct. According to Department of Health Professions (DHP), the Board currently does not have authority to take action against licensed veterinarians if they commit fraud, deceit, or misrepresentation in dealing with the Board or with the customers unless the fraud, deceit, or misrepresentation violates one of the other acts of unprofessional conduct listed in the regulations. The lack of authority is reported to have hindered the ability of the Board to appropriately address complaints against veterinarians in a few cases.

The main benefit of the proposed change is providing authority to the Board to take appropriate action against veterinarians who commit fraud, deceit, or misrepresentation so that public health, safety, and/or welfare of citizens are better protected. In addition, the added authority is likely to discourage acts of fraud, deceit, or misrepresentation before they occur.

The main costs of this proposed change fall on the veterinarians who commit fraud, deceit, or misrepresentation since a disciplinary action may now be taken successfully against them. In such cases, the magnitude of the costs would depend on whether a pre-hearing consent is signed or a hearing is conducted. Depending on the seriousness of violation, the Board may levy a monetary penalty or impose a sanction.

Also, another proposed change clarifies that a veterinarian may delegate duties verbally or in writing in addition to delegation by electronic means. Since this change is a mere clarification of an existing standard, no significant economic effects are expected other than improving the clarity of the language and preventing a potentially costly misunderstanding.

Businesses and Entities Affected. There were 3,720 licensed veterinarians in Virginia at the end of 2010. However, no more than a few fraud, deceit, or misrepresentation cases are expected.

Localities Particularly Affected. The proposed regulations apply throughout the Commonwealth.

Projected Impact on Employment. The proposed regulations are not expected to have a significant impact on employment unless the license of a veterinarian is revoked upon violation of the new standard. In such cases, the supply of veterinarian services would be reduced.

Effects on the Use and Value of Private Property. The proposed regulations are not expected to have a significant impact on the use and value of private property unless a significant penalty including a license revocation levied or imposed on a veterinarian. In such cases, the asset value of the veterinarian practice may be reduced.

Small Businesses: Costs and Other Effects. While most of the regulated veterinarian establishments are believed to be small businesses, the proposed regulations are not expected to create significant costs or other effects on small businesses unless a significant penalty including a license revocation levied or imposed.

Small Businesses: Alternative Method that Minimizes Adverse Impact. There is no known alternative that minimizes potential adverse impact while accomplishing the same goals.

Real Estate Development Costs. The proposed regulations are not expected to create any real estate development costs.

Legal Mandate. The Department of Planning and Budget (DPB) has analyzed the economic impact of this proposed regulation in accordance with § 2.2-4007.04 of the Administrative Process Act and Executive Order Number 14 (10). Section 2.2-4007.04 requires that such economic impact analyses include, but need not be limited to, the projected number of businesses or other entities to whom the regulation would apply, the identity of any localities and types of businesses or other entities particularly affected, the projected number of persons and employment positions to be affected, the projected costs to affected businesses or entities to implement or comply with the regulation, and the impact on the use and value of private property. Further, if the proposed regulation has adverse effect on small businesses, § 2.2-4007.04 requires that such economic impact analyses include (i) an identification and estimate of the number of small businesses subject to the regulation; (ii) the projected reporting, recordkeeping, and other administrative costs required for small businesses to comply with the regulation, including the type of professional skills necessary for preparing required reports and other documents; (iii) a statement of the probable effect of the regulation on affected small businesses; and (iv) a description of any less intrusive or less costly alternative methods of achieving the purpose of the regulation. The analysis presented above represents DPB's best estimate of these economic impacts.

Agency's Response to Economic Impact Analysis: The Board of Veterinary Medicine concurs with the analysis of the Department of Planning and Budget for the proposed fast-track action on unprofessional conduct in 18VAC150-20, Regulations Governing the Practice of Veterinary Medicine.

Summary:

The amendments establish grounds for unprofessional conduct to include committing an act constituting fraud, deceit, or misrepresentation in dealing with the board or in the veterinarian-client-patient relationship and clarify that delegation of duties by a veterinarian may occur by any means, either electronically, in writing, or in person.

Part III
Unprofessional Conduct

18VAC150-20-140. Unprofessional conduct.

Unprofessional conduct as referenced in § 54.1-3807(5) of the Code of Virginia shall include the following:

1. Representing conflicting interests except by express consent of all concerned given after a full disclosure of the facts. Acceptance of a fee from both the buyer and the seller is prima facie evidence of a conflict of interest.

2. Practicing veterinary medicine or equine dentistry where an unlicensed person has the authority to control the professional judgment of the licensed veterinarian or the equine dental technician.

3. Issuing a certificate of health unless he shall know of his own knowledge by actual inspection and appropriate tests of the animals that the animals meet the requirements for the issuance of such certificate on the day issued.

4. Revealing confidences gained in the course of providing veterinary services to a client, unless required by law or necessary to protect the health, safety or welfare of other persons or animals.

5. Advertising in a manner which is false, deceptive, or misleading or which makes subjective claims of superiority.

6. Violating any state law, federal law, or board regulation pertaining to the practice of veterinary medicine, veterinary technology or equine dentistry.

7. Practicing veterinary medicine or as an equine dental technician in such a manner as to endanger the health and welfare of his patients or the public, or being unable to practice veterinary medicine or as an equine dental technician with reasonable skill and safety.

8. Performing surgery on animals in an unregistered veterinary establishment or not in accordance with the establishment permit or with accepted standards of practice.

9. Refusing the board or its agent the right to inspect an establishment at reasonable hours.

10. Allowing unlicensed persons to perform acts restricted to the practice of veterinary medicine, veterinary technology or an equine dental technician including any invasive procedure on a patient or delegation of tasks to persons who are not properly trained or authorized to perform such tasks.

11. Failing to provide immediate and direct supervision to a licensed veterinary technician or an assistant in his employ.

12. Refusing to release a copy of a valid prescription upon request from a client.

13. Misrepresenting or falsifying information on an application or renewal form.

14. Failing to report suspected animal cruelty to the appropriate authorities.

15. Failing to release patient records when requested by the owner; a law-enforcement entity; or a federal, state, or local health regulatory agency.

16. Committing an act constituting fraud, deceit, or misrepresentation in dealing with the board or in the veterinarian-client-patient relationship.

18VAC150-20-172. Delegation of duties.

A. A licensed veterinarian may delegate the administration (including by injection) of schedule VI drugs to a properly trained assistant under his immediate and direct supervision. The prescribing veterinarian has a specific duty and responsibility to determine that the assistant has had adequate training to safely administer the drug in a manner prescribed. Injections involving anesthetic or chemotherapy drugs, subgingival scaling, or the placement of intravenous catheters shall not be delegated to an assistant.

B. Additional tasks that may be delegated by a licensed veterinarian to a properly trained assistant include but are not limited to the following:

1. Grooming;

2. Feeding;

3. Cleaning;

4. Restraining;

5. Assisting in radiology;

6. Setting up diagnostic tests;

7. Prepping for surgery;

8. Dental polishing and scaling of teeth above the gum line (supragingival);

9. Drawing blood samples; or

10. Filling of schedule VI prescriptions under the direction of a veterinarian licensed in Virginia.

C. A licensed veterinarian may delegate duties electronically, verbally, or in writing to appropriate veterinary personnel provided the veterinarian has physically examined the patient within the previous 36 hours.

D. Animal massage or physical therapy may be delegated by a veterinarian to persons qualified by training and experience by an order from the veterinarian.

E. The veterinarian remains responsible for the duties being delegated and remains responsible for the health and safety of the animal.